Individual
SAMUEL B TACKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
123 W NORTH BEAR CREEK DR, MERCED, CA 95348-3420
(209) 722-8161
(209) 383-9211
Mailing address
123 W NORTH BEAR CREEK DR, MERCED, CA 95348-3420
(209) 722-8161
(209) 383-9211
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
G60593
CA
Other
Enumeration date
09/17/2006
Last updated
05/07/2008
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